There have been a number of studies looking at the long-term Quality of Life (QoL) and return to sport in those post-ACL injuries. Based on this systematic review, almost half return to their competitive level sport after ACL reconstruction, and 80% admit to returning to at least some kind of a sport or activity.
Individuals who return to pre-injury sport or activities after their ACL reconstruction report better health-related QoL and less knee symptoms 5–20 years later, compared with those who do not return to their desired sport or activities (Filbay et al 2018).
One may simply say, “…duh, obviously those who have more pain are less likely to ever return to their sport.”
The only catch is that this study showed that knee symptoms was not the most frequently admitted reason for not returning to normal activities, but a fear of re-injury and a lack of trust in the knee were (Taylor et al 2014).
Considering the stat that one in three experience a recurrent ACL tear, perhaps they are justified with being concerned. This is especially concerning as ACL revision surgeries are associated with more pain, reduced function, higher rates of OA and worse QoL (Kievit et al 2013).
Obviously a primary goal in rehab must always be to minimize fear and maximize trust in the knee through graded exposure to activities simulating their desired activities as possible and permitted post-op.